ASCRS 2006

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ASCRS 2006

• Capt Robert Lyons USAF, MC, FS1
• Lt Col R.Gary Lane USAF, MC, FS1
• Natascha Minidis, MSIV2
• 1 Wilford Hall Medical Center
• 2 NOVA Southeastern University College of
  Osteopathic Medicine

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Title

• Ophthalmology or Optometry
• A survey investigating
• the willingness of
• potential surgery amongst
• the general population

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While at ASCRS 2005

• Poster
• Marina Feldman
• Title Does Uncertainty Exist Among Medical
  Students Regarding the Definitions of
  Ophthalmology and Optometry?
• Purpose To determine knowledge and opinions of
  medical students about the different kinds of
  eye-care providers and the services they provide

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ASCRS 2005

• Methods A two-page survey administered to 280
  medical studentswere asked questions that tested
  their knowledge of differences among
  ophthalmologists, optometrists and opticians
• Conclusion There is considerable uncertainty,
  even among medical school students, with regard
  to the differences among eye care professionals
  and services they provide.

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More Recently

• Ocular Surgery News Jan. 2006
• National Consumer League Survey
• 600 online respondents
• 500 from 49 states, 100 from Oklahoma
• 53 routinely seen by optometry, 28 by
  ophthalmology
• Asked differences between eye professionals
• Asked preferences regarding eye professionals

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NCL Survey

• Findings
• Confusion about credentials required
• Board certification vs. licensure
• Medical training vs. no medical training
• Majority preferred ophthalmology when asked
  hypothetically where to seek care for eye
  diseases
• Optometry was preferred for slow gradual vision
  loss

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NCL Survey

• Overwhelming preference for eye care provider to
  have a medical degree for
• Eye Surgery (91)
• Laser Surgery (89)
• Injecting/prescribing Medications (82)
• Emergency Care (86)
• Also strongly agreed with following
• Only skilled, licensed medical doctors should
  perform surgery
• Patients should be told in advance of receiving
  eye care if provider is trained, licensed medical
  doctor
• Laser vision correction, laser cutting into the
  eye, and procedures with a scalpel are all
  considered surgery

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NCL Survey

• After reading provider profiles
• 92 preferred ophth to prescribe oral meds
• 88 preferred ophth to prescribe drops
• 93 preferred ophth to inject meds
• 95 preferred ophth for surgery
• 95 preferred ophth for laser surgery
• Optom was preferred
• for testing
• and fitting glasses and
• contact lenses

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Why is this important?

• 2005
• Texas and New Mexico had legislature introduced
  in an attempt to increase the scope of practice
  for optometry, to include laser surgery and
  surgery with a scalpel
• Oklahoma Board of Optometry allows laser surgery
  and over 100 surgeries with a scalpel
• Currently being battled
• in the state legislature

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Purpose

• To determine what percentage of the population
  would be willing to have surgery performed by an
  optometrist if legislation were introduced
  allowing optometrists to perform surgery

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Methods

• Telephone survey in San Antonio, TX
• 364 respondents
• Completely anonymous
• Randomly selected telephone numbers
• Consent was granted by subjects willingness to
  complete survey
• Difference from NCL study
• Subjects naïve to differences between eye
  professionals

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Survey

• How old are you?
• Would you have eye surgery, if you were told you
  needed it, performed by an optometrist?
• Have you seen an eye care professional in the
  last three years?
• If yes, did you see an
• optometrist or an
• ophthalmologist?

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Age of subjects
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Have you been seen by an eye care professional in
last 3 years?
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Would you have surgery by an optometrist?
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p0.10 p0.8328
p0.0070(two tailed t-test)
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Results

• This survey contrasts to what had previously been
  published by the NCL study
• Statistically significant to have seen an
  optometrist (p0.0070) in deciding whether to
  have surgery by an optometrist

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Strengths/Weaknesses

• Strengths
• Relevant to current issues
• Unique study (naïve subjects)
• Good follow-on to NCL study

• Weaknesses
• Based on local population
• Small sample size for inter-group analysis
• Telephone results may not carry over to real
  world results

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Conclusions

• There is a misunderstanding in the general
  population regarding the differences in the
  qualifications between an optometrist and
  ophthalmologist.
• Despite the strong preference for medical doctors
  to perform surgery outlined in the NCL study, the
  results of this survey demonstrate the need for
  further education regarding the roles of eye care
  professionals